Claim total
$10,483.10
base $155.66 · payer covered $10,433.10
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-11-29
- Stop
- 2017-11-29
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-d908-e14df6a95026